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NPI Code Detail

MEDICARE: DR. ANGELA POLLOCK LOUGHERY PHARMD

MEDICARE: DR. ANGELA POLLOCK LOUGHERY PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist35809TN

General Provider Information

NPI Number : 1720362205
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA POLLOCK LOUGHERY PHARMD
Provider Business Mailing Address
First Line : 334 GOLDEN DR
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37040-4497
Country : US
Telephone Number : 931-237-2724
Fax Number :
Provider Business Practice Location Address
First Line : 1954 MADISON ST
Second Line :
City : CLARKSVILLE
State : TN
Zip : 37043-8038
Country : US
Telephone Number : 931-552-8108
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2011
Last Update Date : 10/03/2011

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